HLA半相合造血干细胞移植治疗首次复发的急性髓系白血病

目的 探讨遗传上HLA半相合外周血造血干细胞移植(Haplo-PBSCT)对首次复发后的成人急性髓系白血病(AML)的治疗效果.方法 89例成人AML患者接受常规柔红霉素-高剂量阿糖胞苷(DA/Hi-Ara-C)化疗缓解后出现首次复发,其中复发后接受Haplo-PBSCT治疗者53例,平均年龄38.6岁(18～51岁),复发时间为首次缓解后7.7个月(1～24个月);接受去甲氧柔红霉素-中剂量阿糖胞苷(iDA/Mid-Ara-C)或米托蒽醌-中剂量阿糖胞苷(MA/Mid-Ara-C)方案继续化疗者26例,平均年龄47.6岁(18～61岁),复发时间为首次缓解后8.9个月(1～30个月).结果 接受Haplo-PBSCT治疗者和接受化疗者再次完全缓解率(CR)分别为86.7%(46/53)和38.1%(9/23),两者比较,差异有统计学意义(P＜0.01).接受Haplo-PBSCT治疗者和接受化疗者36个月的疾病进展后存活(SPP)率分别为43.4%(23/53)和11.5%(3/26),两者比较,差异有统计学意义(P＜0.05).结论 相对于接受iDA/Mid-Ara-C或MA/Mid-Ara-C方案继续化疗者,Haplo-PBSCT能明显提高首次复发后AML患者的再次缓解率以及延长SPP时间.

Abstract：

Objective To investigate the therapeutic effects of haploidentical hematopoietic stem-cell transplantation (Haplo-PBSCT) for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy. Methods Eighty-nine cases of AML in first relapse after complete remission by standard DA/Hi-Ara-C regimens induction chemotherapy were evaluated retrospectively. Fiftythree cases were grafted by haplo-PBSCT and 26 cases were treated with iDA/Mid-Ara-C or MA/ Mid- Ara-C agents. Results The second remission rate in haplo-PBSCT group and continuous chemotherapy group was 86. 7 % (46/53 cases) and 38. 1% (9/23 cases) respectively (P＜0. 01). Survival postprogression (SPP) at 36th month was 43. 4 % (23/53 cases) in haplo-PBSCT group and 11.5 % (3/26 cases) in continuous chemotherapy group (P ＜ 0. 05). Conclusion Haplo-PBSCT could significantly increase the second remission rate and prolong the survival time of patients with acute myeloid leukernia in first relapse after complete remission by standard induction chemotherapy.

Haploidentical hematopoietic stem-cell transplantation for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy

Objective To investigate the therapeutic effects of haploidentical hematopoietic stem-cell transplantation (Haplo-PBSCT) for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy. Methods Eighty-nine cases of AML in first relapse after complete remission by standard DA/Hi-Ara-C regimens induction chemotherapy were evaluated retrospectively. Fiftythree cases were grafted by haplo-PBSCT and 26 cases were treated with iDA/Mid-Ara-C or MA/ Mid- Ara-C agents. Results The second remission rate in haplo-PBSCT group and continuous chemotherapy group was 86. 7 % (46/53 cases) and 38. 1% (9/23 cases) respectively (P＜0. 01). Survival postprogression (SPP) at 36th month was 43. 4 % (23/53 cases) in haplo-PBSCT group and 11.5 % (3/26 cases) in continuous chemotherapy group (P ＜ 0. 05). Conclusion Haplo-PBSCT could significantly increase the second remission rate and prolong the survival time of patients with acute myeloid leukernia in first relapse after complete remission by standard induction chemotherapy.